Agreement Is Reached On Lyme Disease

Short-term Treatment Will Undergo Review

May 02, 2008|By HILARY WALDMAN; Courant Staff Writer

Controversial treatment guidelines that say most cases of Lyme disease can be cured simply with a month's worth of antibiotic pills will be subjected to an independent review under an agreement announced Thursday by Attorney General Richard Blumenthal.

The treatment standards, developed by the Infectious Diseases Society of America, came under sharp criticism in some circles because they downplayed a view held by some Lyme disease patients and doctors that the tick-borne bacteria can linger in the bloodstream for years and cause debilitating chronic symptoms.

Blumenthal, long a hero of the so-called chronic Lyme camp, launched an investigation into complaints that treatment guidelines were crafted by infectious disease society scientists who were biased against the idea that some patients require intravenous antibiotics for six months or more to get relief.

Announcing the results of the antitrust investigation in his Hartford office Thursday, Blumenthal said he found evidence that members of the infectious disease society who wrote the guidelines had personal and professional financial stakes in companies that make or develop Lyme disease tests and treatments.

Blumenthal said the financial conflicts went beyond those publicly disclosed in 2006 when the infectious disease society published the guidelines. He did not, however, name individual scientists or say what they stood to gain from the financial relationships.

"What happened in this process, what made it so flawed, is it excluded information," Blumenthal said. "The cause of that excluding of evidence was financial concern."

Under the agreement, which Blumenthal stressed is cooperative and not a legal settlement, the Infectious Diseases Society of America has agreed to name an independent panel of experts to review the guidelines.

Members of the new board cannot have served on the original panel that developed the guidelines and must be approved by an independent ombudsman who is an expert in medical ethics, and in widely reported conflicts between the medical profession and the pharmaceutical industry.

Dr. Donald Poretz, president of the infectious disease society, said his group agreed to the independent review to put the matter to rest. He said society members had nothing to gain by recommending short-term treatment with generic drugs.

Poretz said that panel members who may have invested in companies that make Lyme disease drugs could have made more money if they recommended long-term treatment with expensive antibiotics.

"In fact," Poretz said, "the panel members denied themselves and their colleagues an opportunity to generate a significant amount of revenue."

The infectious disease society also denied Blumenthal's claim that in 2000 it "booted" a member from a panel developing treatment guidelines because the unnamed member argued that chronic and persistent Lyme disease exists.

Since the guidelines came out two years ago, two prominent medical groups, The American Medical Association and the American Academy of Neurology, also have published findings that there is no compelling evidence to support long-term use of antibiotics for long-term symptoms that some believe are connected to Lyme disease.